Diagnostic strategy of metagenomic next-generation sequencing for gram negative bacteria in respiratory infections

被引:3
作者
Liang, Wenyan [1 ]
Zhang, Qun [1 ]
Qian, Qian [2 ]
Wang, Mingyue [1 ]
Ding, Yuchen [1 ]
Zhou, Ji [1 ]
Zhu, Yi [1 ]
Jin, Yu [1 ]
Chen, Xuesong [1 ]
Kong, Hui [1 ]
Song, Wei [1 ]
Lu, Xin [3 ]
Wu, Xiaodong [4 ]
Xu, Xiaoyong [5 ]
Dai, Shanling [1 ]
Sun, Wenkui [1 ]
机构
[1] Nanjing Med Univ, Affiliated Hosp 1, Dept Respirol & Crit Care Med, Nanjing 210029, Peoples R China
[2] Jiangsu Hlth Vocat Coll, Nanjing 211800, Peoples R China
[3] Nanjing Med Univ, Affiliated Jiangning Hosp, Dept Resp & Crit Care Med, Nanjing, Peoples R China
[4] Tongji Univ, Shanghai East Hosp, Dept Resp & Crit Care Med, Shanghai, Peoples R China
[5] Nanjing Univ Chinese Med, Affiliated Hosp 2, Dept Resp & Crit Care Med, Nanjing 210000, Jiangsu, Peoples R China
关键词
Metagenomic next-generation sequencing; Gram-negative bacteria; Interpretational approaches; Diagnostic accuracy; COMMUNITY-ACQUIRED PNEUMONIA;
D O I
10.1186/s12941-024-00670-x
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
ObjectiveThis study aims to identify the most effective diagnostic method for distinguishing pathogenic and non-pathogenic Gram-negative bacteria (GNB) in suspected pneumonia cases using metagenomic next-generation sequencing (mNGS) on bronchoalveolar lavage fluid (BALF) samples.MethodsThe effectiveness of mNGS was assessed on BALF samples collected from 583 patients, and the results were compared with those from microbiological culture and final clinical diagnosis. Three interpretational approaches were evaluated for diagnostic accuracy.ResultsmNGS outperformed culture significantly. Among the interpretational approaches, Clinical Interpretation (CI) demonstrated the best diagnostic performance with a sensitivity of 87.3%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 98.3%. CI's specificity was significantly higher than Simple Interpretation (SI) at 37.9%. Additionally, CI excluded some microorganisms identified as putative pathogens by SI, including Haemophilus parainfluenzae, Haemophilus parahaemolyticus, and Klebsiella aerogenes.ConclusionProper interpretation of mNGS data is crucial for accurately diagnosing respiratory infections caused by GNB. CI is recommended for this purpose.
引用
收藏
页数:7
相关论文
共 39 条
[11]   The Microbiome and the Respiratory Tract [J].
Dickson, Robert P. ;
Erb-Downward, John R. ;
Martinez, Fernando J. ;
Huffnagle, Gary B. .
ANNUAL REVIEW OF PHYSIOLOGY, VOL 78, 2016, 78 :481-504
[12]   Detection of selected fastidious bacteria [J].
Doern, GV .
CLINICAL INFECTIOUS DISEASES, 2000, 30 (01) :166-173
[13]   Composition and diversity analysis of the lung microbiome in patients with suspected ventilator-associated pneumonia [J].
Fenn, Dominic ;
Abdel-Aziz, Mahmoud, I ;
van Oort, Pouline M. P. ;
Brinkman, Paul ;
Ahmed, Waqar M. ;
Felton, Timothy ;
Artigas, Antonio ;
Povoa, Pedro ;
Martin-Loeches, Ignacio ;
Schultz, Marcus J. ;
Dark, Paul ;
Fowler, Stephen J. ;
Bos, Lieuwe D. J. .
CRITICAL CARE, 2022, 26 (01)
[14]   Adult Bacterial Meningitis: Earlier Treatment and Improved Outcome Following Guideline Revision Promoting Prompt Lumbar Puncture [J].
Glimaker, Martin ;
Johansson, Bibi ;
Grindborg, Orjan ;
Bottai, Matteo ;
Lindquist, Lars ;
Sjolin, Jan .
CLINICAL INFECTIOUS DISEASES, 2015, 60 (08) :1162-1169
[15]   Rapid pathogen detection by metagenomic next-generation sequencing of infected body fluids [J].
Gu, Wei ;
Deng, Xianding ;
Lee, Marco ;
Sucu, Yasemin D. ;
Arevalo, Shaun ;
Stryke, Doug ;
Federman, Scot ;
Gopez, Allan ;
Reyes, Kevin ;
Zorn, Kelsey ;
Sample, Hannah ;
Yu, Guixia ;
Ishpuniani, Gurpreet ;
Briggs, Benjamin ;
Chow, Eric D. ;
Berger, Amy ;
Wilson, Michael R. ;
Wang, Candace ;
Hsu, Elaine ;
Miller, Steve ;
DeRisi, Joseph L. ;
Chiu, Charles Y. .
NATURE MEDICINE, 2021, 27 (01) :115-+
[16]  
Hoyler SL, 2001, J NATL MED ASSOC, V93, P224
[17]   Community-Acquired Pneumonia Requiring Hospitalization among US Adults [J].
Jain, S. ;
Self, W. H. ;
Wunderink, R. G. ;
Fakhran, S. ;
Balk, R. ;
Bramley, A. M. ;
Reed, C. ;
Grijalva, C. G. ;
Anderson, E. J. ;
Courtney, D. M. ;
Chappell, J. D. ;
Qi, C. ;
Hart, E. M. ;
Carroll, F. ;
Trabue, C. ;
Donnelly, H. K. ;
Williams, D. J. ;
Zhu, Y. ;
Arnold, S. R. ;
Ampofo, K. ;
Waterer, G. W. ;
Levine, M. ;
Lindstrom, S. ;
Winchell, J. M. ;
Katz, J. M. ;
Erdman, D. ;
Schneider, E. ;
Hicks, L. A. ;
McCullers, J. A. ;
Pavia, A. T. ;
Edwards, K. M. ;
Finelli, L. .
NEW ENGLAND JOURNAL OF MEDICINE, 2015, 373 (05) :415-427
[18]   16S rRNA gene sequencing for bacterial identification in the diagnostic laboratory: Pluses, perils, and pitfalls [J].
Janda, J. Michael ;
Abbott, Sharon L. .
JOURNAL OF CLINICAL MICROBIOLOGY, 2007, 45 (09) :2761-2764
[19]   Improving Suspected Pulmonary Infection Diagnosis by Bronchoalveolar Lavage Fluid Metagenomic Next-Generation Sequencing: a Multicenter Retrospective Study [J].
Jin, Xiao ;
Li, Juan ;
Shao, Mingyue ;
Lv, Xuedong ;
Ji, Ningfei ;
Zhu, Yehan ;
Huang, Mao ;
Yu, Feichao ;
Zhang, Changwen ;
Xie, Lixu ;
Huang, Jianling ;
Chen, Sixi ;
Zhu, Changjun ;
Lv, Minjie ;
Feng, Ganzhu .
MICROBIOLOGY SPECTRUM, 2022, 10 (04)
[20]   New consensus guidelines from the clinical and laboratory standards institute for antimicrobial susceptibility testing of infrequently isolated or fastidious bacteria [J].
Jorgensen, James H. ;
Hindler, Janet F. .
CLINICAL INFECTIOUS DISEASES, 2007, 44 (02) :280-286